The N.Y. Face vs. the L.A. Face: Top Plastic Surgeons Reveal Biggest Differences

Illustration by: Kristina Collantes

THR also spoke to dermatologists about the procedural and psychological differences between constructed-beauty ideals on both coasts.

This story first appeared in the April 24 issue of The Hollywood Reporter magazine.

These days, when it comes to the polarization of New York and Los Angeles, you can look straight at the face. Think Robin Wright versus Meg Ryan, and in a blink of a tautened eye, it's clear who has "New York face" and who has "L.A. face" among the over-40 female set. According to each city's most elite skin doctors, what George Orwell said about wearing your true face at 50 never has been less true — particularly for Angelenos.

"In New York, my patients want to look like themselves but better," says New York plastic surgeon Sherrell Aston. "On the West Coast, there's more of an 'operated look': lips too big, noses up too high, more forehead lifts." New York derm Patricia Wexler agrees. "New York women want their faces to move," she says, "not that 'pit bull look' [in L.A.]: Faces filled artificially are too round and bloated." Compare that to New York, "where Robin Wright is a tasteful example of over 40," says derm David Colbert, who has star clientele on both coasts. Wright, 49, now a New Yorker, admitted to "just the tiniest sprinkle of Botox twice a year. Most women do 10 units, which freezes the face; I do one." Adds Colbert, "Women in New York tell me they don't want to look like they're 'from Los Angeles.' " Even Dr. Larry Koplin, a top Beverly Hills surgeon, agrees: "You don't see any Michael Jackson types or trout mouths in New York. They do a better job making people less exaggerated and cartoony. In L.A., that's what patients ask for."

New York plastic surgeon Gerald Imber comments on the "different gestalts" of the two cities: From the consultation rooms to the attitudes of the doctors, "we are influenced by environment." As such, the goals of appearance are very different. "New York women want a tougher face," says Beverly Hills dermatologist Ava Shamban. "It's slightly more masculine: a stronger chin, jaw and nose. In L.A., it's more of a sweet, feminine face: a bigger lip and more slender noses. The standards of beauty relate to the values of the city." In other words, one town's known for celebrity and sex while the other celebrates power and money.

With New York more resistant to youth culture, face-lift patients start older, notes Imber. "The standards are pretty different: In New York, a 50-year-old woman can be the hottest woman in the room." Shamban sums up the age differentiation: "In New York, women want to look 40; in L.A., 20." For either city, there's also a practical consideration, says Peggy Siegal, the New York PR doyenne who discussed her two face-lifts (with Dr. Imber) in a pamphlet she handed out at her 60th birthday party, How to Look Like Me at 60: "Older women face age discrimination in the job market. Stopping the clock to a degree is the best way of eradicating that."

The East Coast may have its subtlety, but the West Coast has expertise. While the same procedures are popular in both cities — fillers, Botox, face- and eye-lifts — L.A. is ahead of New York in perfecting fat transfers and laser resurfacing. "In L.A., we don't just think about pulling," says Beverly Hills derm Peter Kopelson. "We think about replacing lost volume — and the people who are best at fillers are the ones who apply them most often."

Registered nurse Jamie Sherrill, known as Nurse Jamie to her A-list clients, adds that subtlety is on the rise in Hollywood and deploys what she calls "baby Botox": "My 'Gucci' needle allows for only one drop. There's a much more natural result." She also says New York patients are more incremental and cautious, paying for consultations, then coming back for Botox, then returning for fillers, "so they pay a lot more money." A brief survey among top doctors reveals that procedures in L.A. are about 30 percent lower in price (Botox from $900 in L.A. for 40-plus units to smooth out forehead, frown lines and crow's feet versus $1,200 in New York; L.A. eyelid lifts start at $3,500, New York's $5,000), but L.A. patients receive twice as many filler, laser and Botox treatments as New Yorkers.

Skin appearance is prized differently, too, says Shamban: "In New York, while they dress beautifully, they often have bad or uneven skin. And they drink too much. In L.A., the women have softer and clearer skin due to the weather." And almost every doctor conceded that "in L.A., there's a tradition of seeing a perfection that no one can achieve," to quote Imber. What that perfection really means is symmetry, as in Leonardo da Vinci's Golden Ratio: an equation mathematicians have found in everything the human eye finds beautiful. Dr. Kopelson, for one, has no problem with that: "So women in L.A. are chasing perfection. But you have to admit, they get much closer to it than women anywhere else."

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